UROGENITAL TRACT Male Development
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Transcript of UROGENITAL TRACT Male Development
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UROGENITAL TRACT
Male DevelopmentMale Development
RICHARD SCHLUSSEL, M.D.
DEPARTMENT OF UROLOGY
DIVISION OF PEDIATRIC UROLOGY
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Genital Development
• Chromosomal sex
• Gonadal sex
• Phenotypic sex
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Week 5
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• Chromosomal sexChromosomal sex
• Gonadal sex
• Phenotypic sex
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Chromosomal sex
• SRY geneSSex determining
RRegion of the
YY chromosome
- transcription factor
SOX 9
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Gonadal sex
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Gonadal sex
• Sertoli cells– Forms week 6– Organizes testis into
cords– Secrete AMH week 8Anti Mullerian Hormone
– Leydig cell development
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Gonadal sex
• Sertoli cells– Forms week 6– Organizes testis into
cords– Secrete AMH week 8
Anti
Mullerian
Hormone– Leydig cell
development
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AMH
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Gonadal sex
• Leydig cells– Secrete Testosterone
• Week 9-10
– Preserve mesonephric ducts
– Regulated by chorionic gonadotropin
• Placenta• Pituatary
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• Chromosomal sex
• Gonadal sex
• Phenotypic sex– Internal genitalia (T)– External genitalia (DHT)
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Phenotypic sex
• Androgens– Testosterone (T)– Dihydrotestosterone
(DHT)
• Androgen receptors
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Testicular descent
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Normal Male Genitalia
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Disordered development
• Klinefelter’s syndrome
• XX males
• Male pseudohermaphrodite
• Testicular feminization
• Persistent Mullerian duct syndrome
• Hypospadias
• Undescended testes
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Klinefelter’s syndrome
• Chromosomal sex– Failure meiosis– Disjunction– XXY
• Gonadal sex
• Phenotypic sex
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Klinefelter’s syndrome XXY
• Small firm testes• Gynecomastia• Seminiferous
tubular sclerosis • High gonadotropins
FSH• 1 of 600 males
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Hermaphrodite (Intersex)
• “An individual having the reproductive organs and many of the secondary sex characteristics of both sexes”
• “a discrepancy between the external genitals and the internal genitals”
• Hermaphroditus– the son of Hermes and Aphrodite– was fused with a nymph
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Male pseudohermaphrodite
• Chromosomal sex
• Gonadal sex
• Phenotypic sex
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Male pseudohermaphrodite
XY chromosomes!!
5α-reductase deficiency
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Testicular feminization(Androgen insensitivity)• Chromosomal sex
• Gonadal sex
• Phenotypic sex
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Testicular feminization(Androgen insensitivity)
XY chromosomes!!
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Hypospadias
• Abnormal androgen production
• Abnormal androgen sensitivity
• Arrested development
• Estrogen
exposure
?
??
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Hypospadias
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Hypospadias
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Hypospadias
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Undescended Testes3 MONTHS
7 MONTHS-Gubernaculum
-Endocrine
- Insulin like factor3
-Genitofem nerve
- CGRP (calcitonin gene Related Protein)
9 MONTHS
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Undescended Testes
• Infertility
• Neoplasia
• Cosmesis
• Testis torsion
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• Chromosomal sex
• Gonadal sex
• Phenotypic sex
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• Chromosomal sex
• Gonadal sex
• Phenotypic sex
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• Persistent mullerian duct
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Figure 106-20 Formation of genital ridges and paramesonephric ducts. A, During the 5th and 6th weeks, the genital ridges form in the posterior abdominal wall just medial to the developing mesonephros. The primordial germ cells induce the coelomic epithelial cells lining the peritoneal cavity and the cells of the mesonephros to proliferate and form the primitive sex cords. B, During the 6th week, the paramesonephric ducts develop lateral to the mesonephros. The caudal tips of the paramesonephric ducts fuse with each other as they connect with the urogenital sinus. (Modified from Larsen WJ: Human Embryology. New York, Churchill Livingstone, 1997.)
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